GPs back new Scottish contract despite fears over practice staffing and profits

GP leaders have signalled overwhelming support for Scotland's landmark new contract despite warnings that it may eventually erode family doctors' ability to boost practice profits and hire their own staff.

GPs from across Scotland will be asked to vote on the proposed new general practice contract for Scotland in January, but during a special conference organised by BMA Scotland in Clydebank representatives from the local medical committees agreed by around 80 per cent that the measures would ensure more sustainable funding for general practice while reducing some of the financial risks associated with being a GP partner.

The proposals include a minimum income for GP partners of £80,430 - after research by the BMA indicated that a fifth of GPs in Scotland were earning less than £70,000 for a 40-hour week - axing a financial penalty for failing to offer out-of-hours care, and interest-free loans towards the upkeep of premises.

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One delegate said the proposals had persuaded his daughter and her boyfriend - both GPs based in Manchester - to freeze plans to emigrate to New Zealand and were now considering a career in Scotland instead.

Dr Alan McDevitt, chair of BMA Scotland's GP Committee, said no practice in Scotland would be left worse off despite fears among rural GPs that the contract's new funding formula will disproportionately benefit urban surgeries with high elderly and deprived caseloads, and said it would give doctors "more time with patients".

It came as Health Secretary Shona Robison announced an extra £7.5 million in 2018-19 to help recruit and retain GPs. It includes 'golden hello' payments for 160 remote and rural practices to lure GPs to rural Scotland for the first time, with additional relocation packages of up to £5,000 also available. Half all GP training bursaries will also be attached to rural practices.

She revealed that the Scottish Government has also set a target to increase the number of GPs working in Scotland by 800 over the next 10 years, and would launch a UK and global marketing campaign in 2018 to encourage GPs to come to Scotland.

In a passionate speech to the conference, Ms Robison said the funding boost combined with the contract would have a "significant impact on improving GP recruitment and retention" at a time when general practice has struggled with record vacancies. She added: "Everything we have promised to deliver, we will deliver."

However, some delegates said plans to hand the responsibility for employing practice support staff from GPs to health boards may backfire.

A beefed-up multidisciplinary team - including a pharmacist for every practice who will be patients first port of call for medication problems - is among the key planks in the contract designed to reduce GPs' workload.

One said: "I worry that if the pharmacist is off sick or goes on maternity leave, how often will they be replaced if the health board is in control of the purse strings? Will the GP be expected to pick up their work?"

The contract's second phase, expected to take effect in two to three years subject to another GP vote, will introduce controls on GP take-home pay - currently unlimited under the independent contractor model.

However, one delegate warned that removing the profit incentive "will stifle innovation and crush the talent pool in general practice".

Mr McDevitt said phase two "only goes forward if you [GPs] agree to it".

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